Sample Respiratory Protection Program by mariolopez


  (UOSH Sample Program)

         July 2004
Sample Respiratory Protection Program

This Sample Respiratory Protection Program is for a hypothetical
company that has chosen to interpret certain provisions of 29 CFR
1910.134 in ways that could be different from the way another company
might choose to implement it.
The following checklist is provided to assist the employer in
determining if their respiratory protection program contains all the
required elements. The checklist itself is not included in the written

A written respiratory program that is specific to your workplace and
covers the following:
   Procedures for selecting respirators.
   Medical evaluations for employees required to wear respirators.
   Fit testing procedures.
   Routine use procedures and emergency respirator use procedures.
   Procedures for ensuring adequate air quality for supplied air
   Training in respiratory hazards.
   Training in proper use and maintenance of respirators.
   Program evaluation procedures.
   Procedures for ensuring that workers who voluntarily wear
     respirators (excluding filtering face-pieces) comply with the
     medical evaluation, and cleaning, storing and maintenance
     requirements of the standard.

Designate a program administrator who is qualified to administer the

Update the written program as necessary to account for changes in the
workplace affecting respirator use.

Provide equipment, training, and medical evaluation at no cost to

                      TABLE OF CONTENTS
1.0 Purpose
2.0 Scope
3.0 Responsibilities
   Program Administrator
4.0 Program Elements
    Selection Procedures
    Cartridge/Canister Change Schedule For Vapors and Gases
    Particulate Protection
    Updating the Hazard Assessment
    Voluntary Respirator Use
    Medical Evaluation
    Fit Testing
    Respirator Use
    Procedures for IDLH
    Procedures for Interior Structural Fire Fighting
    Cleaning & Disinfecting
    When To Inspect
    What To Inspect
    Emergency Respirators
    Defective Respirators
    Breathing Air Quality and Use
    Training and Information
5.0 Program Evaluation
6.0 Recordkeeping

1.0 Purpose
(Company Name) has determined that employees in the (state area) are
exposed to respiratory hazards during routine operations. These hazards
include (state hazard e.g. wood dust, particulate, and vapors), and in
some cases represent Immediately Dangerous to Life or Health (IDLH)
conditions. The purpose of this program is to ensure that all (company
name) employees are protected from exposure to these respiratory

Engineering controls, such as ventilation and substitution of less toxic
materials, are the first line of defense at (Company Name); however,
engineering controls have not always been feasible for some of our
operations, or have not always completely controlled the identified
hazards. In these situations, respirators and other protective equipment
must be used. Respirators are also needed to protect employees' health
during emergencies. The work processes requiring respirator use at
(Company Name) are outlined in Table 1 in the Program Elements

In addition, some employees have expressed a desire to wear respirators
during certain operations that do not require respiratory protection. As a
general policy (Company Name) will review each of these requests on a
case-by-case basis. As outlined in the Scope section of this program,
voluntary respirator use is subject to certain requirements of this

2.0 Scope
This program applies to all employees who are required to wear
respirators during normal work operations, and during some non-routine
or emergency operations such as a spill of a hazardous substance. This
includes employees in the (state area). All employees working in these
areas and engaged in certain processes or tasks (as outlined in the table
below) must be enrolled in the company's respiratory protection

In addition, this program applies to any employee who voluntarily wears
a respirator when a respirator is not required.

Employees participating in the respiratory program do so at no cost to
them. The expense associated with training, medical evaluations and
respiratory protection equipment will be borne by the company.
3.0 Responsibilities

Program Administrator
The Program Administrator is responsible for administering the
respiratory protection program. Duties of the program administrator
    Identifying work areas, processes or tasks that require workers to
      wear respirators, and evaluating hazards.
    Selection of respiratory protection options.
    Monitoring respirator use to ensure that respirators are used in
      accordance with their certifications.
    Arranging for and/or conducting training.
    Ensuring proper storage and maintenance of respiratory protection
    Conducting qualitative fit testing with Bitrex.
    Administering the medical surveillance program.
    Maintaining records required by the program
    Evaluating the program.
    Updating written program, as needed.
      The Program Administrator for (company name) is
      ___________________________ .

Supervisors are responsible for ensuring that the respiratory protection
program is implemented in their particular areas. In addition to being
knowledgeable about the program requirements for their own protection,
supervisors must also ensure that the program is understood and
followed by the employees under their charge. Duties of the supervisor
    Ensuring that employees under their supervision (including new
     hires) have received appropriate training, fit testing, and annual
     medical evaluation.
    Ensuring the availability of appropriate respirators and accessories.
    Being aware of tasks requiring the use of respiratory protection.
    Enforcing the proper use of respiratory protection when necessary.
    Ensuring that respirators are properly cleaned, maintained, and
     stored according to the respiratory protection plan.
     Ensuring that respirators fit well and do not cause discomfort.
     Continually monitoring work areas and operations to identify
      respiratory hazards.
     Coordinating with the Program Administrator on how to address
      respiratory hazards or other concerns regarding the program.

Each employee has the responsibility to wear his or her respirator when
and where required and in the manner in which they were trained.
Employees must also:
   Care for and maintain their respirators as instructed, and store them
     in a clean sanitary location.
   Inform their supervisor if the respirator no longer fits well, and
     request a new one that fits properly.
   Inform their supervisor or the Program Administrator of any
     respiratory hazards that they feel are not adequately addressed in
     the workplace and of any other concerns that they have regarding
     the program.
4.0 Program Elements

Selection Procedures
The Program Administrator will select respirators to be used on site,
based on the hazards to which workers are exposed and in accordance
with all OSHA standards. All respirators must be certified by the
National Institute for Occupational Safety and Health (NIOSH) and shall
be used in accordance with the terms of that certification. Also, all
filters, cartridges, and canisters must be labeled with the appropriate
NIOSH approval label. The label must not be removed or defaced while
it is in use.

The Program Administrator will conduct a hazard evaluation for each
operation, process, or work area where airborne contaminants may be
present in routine operations or during an emergency. The hazard
evaluation will include:
    Identification and development of a list of hazardous substances
     used in the workplace, by department, or work process.
   Review of work processes to determine where potential exposures
    to these hazardous substances may occur. This review shall be
    conducted by surveying the workplace, reviewing process records,
    and talking with employees and supervisors.
   Respiratory hazard will be identified and evaluated through
    reasonable estimates using methods such a monitoring.

                  AT (COMPANY NAME)
       Respirator                Department/Process                Hazard
Respirator type and       State where the respirator is used   State the
cartridge type                                                 hazards
EXAMPLE                   __________ area                      Paint vapors
Half face, organic filter
EXAMPLE                   __________ area                      Emergency
SCBA                                                           evacuation
EXAMPLE                   __________ area                      Wood dust
Dust Filtering face piece

A sufficient number of respirator models and sizes must be available to
ensure correct fit.

Immediately Dangerous to Life and Health (IDLH)
The Program Administrator has identified the following area as
presenting the potential for IDLH conditions: (state area(s)). The
following respirators will be supplied for the employees use in
Immediately Dangerous to Life and Health (IDLH): (example,
atmosphere supplying respirator)

Cartridge/Canister Change Schedule for Vapors and Gases
(Company Name) will provide an atmosphere supplying respirator or an
air purifying respirator with and end-of-service-life indicator (ESLI). If
no ESLI the company will implement a change schedule as follows:
(Data and information relied upon to establish the schedule must be
included in the respirator program, for example manufacture
recommendations and objective information).
Particulate Protection
(Company Name) will provide an atmosphere supplying respirator or an
air purifying respirator with a NIOSH certified filter.

Updating the Hazard Assessment
The Program Administrator must revise and update the hazard
assessment as needed (i.e., any time work process changes may
potentially affect exposure). If an employee feels that respiratory
protection is needed during a particular activity, he/she is to contact his
or her supervisor or the Program Administrator. The Program
Administrator will evaluate the potential hazard, arranging for outside
assistance as necessary. The Program Administrator will then
communicate the results of that assessment back to the employees. If it
is determined that respiratory protection is necessary, all other elements
of this program will be in effect for those tasks and this program will be
updated accordingly.

Voluntary Respirator Use
(Company name) will provide respirators at no charge to employees for
voluntary use for the following work processes:
   Employees may wear half-facepiece APRs with organic vapor
     cartridges while working in the dip coat area.
   Warehouse workers may wear filtering facepieces.
   Spray Booth Operators may wear half-facepiece APRs with
     organic vapor cartridges while cleaning spray guns.
   Maintenance personnel may wear half-facepiece APRs with P100
     cartridges while cleaning spray booth walls, and organic vapor
     cartridges while loading spray guns.

The Program Administrator will provide all employees who voluntarily
choose to wear either of the above respirators with a copy of Appendix
D of the standard. (Appendix D details the requirements for voluntary
use of respirators by employees). Employees choosing to wear a half-
facepiece APR must comply with the procedures for Medical
Evaluation, Respirator Use, and Cleaning, Maintenance and Storage.
The Program Administrator shall authorize voluntary use of respiratory
protective equipment as requested by all other workers on a case-by-case
basis, depending on specific workplace conditions and the results of the
medical evaluations.

Medical Evaluation
Employers must provide a medical evaluation to determine each
employee's fitness to wear a respirator. The evaluation must be provided
before the initial fit-testing and before the respirator is used for the first
time. Medical evaluations consist of the administration of a medical
questionnaire, which is found in the mandatory Appendix C of the
standard, or provision of a physical examination that elicits the same
information as the questionnaire for the employee. An employer, who
opts to provide physical examinations to his or her employees, need not
also administer the medical questionnaire. These evaluations are
required for all respirator users except for employees who voluntarily
use dusts masks and for those whose only respirator would be the use of
escape-only respirators. Employees who refuse to be medically
evaluated cannot be assigned to work in areas where they are required to
wear a respirator.
A licensed physician at (state clinic), will provide the medical
evaluations. Medical evaluation procedures are as follows:
    Identify physician or other licensed health care professional
    To the extent feasible, the company will assist employees who are
      unable to read the questionnaire (by providing help in reading the
      questionnaire). When this is not possible, the employee will be sent
      directly to the physician for medical evaluation.
    The medical questionnaire and examinations will be given
      confidentially during the employee's normal working hours or at a
      time and place convenient to the employee. The medical
      questionnaire will be administered in a manner that ensures that the
      employee understands its content.
    Follow-up medical exams will be granted to employees as required
      by the standard, and/or as deemed necessary by the (Clinic name)
      medical clinic physician.
   All employees will be granted the opportunity to speak with the
    physician about their medical evaluation, if they so request.
   The Program Administrator has provided the (Clinic name) clinic
    physician with a copy of this program, a copy of the Respiratory
    Protection Standard, the list of hazardous substances by work area,
    and for each employee requiring evaluation: his or her work area
    or job title, proposed respirator type and weight, length of time
    required to wear respirator, expected physical work load (light,
    moderate, or heavy), potential temperature and humidity extremes,
    and any additional protective clothing required.
   Written recommendation regarding the employees ability to use the
    respirator shall provide only the following information:
    o Limitations on respirator use including whether or not employee
       is medically able to use the respirator.
    o Need for follow up evaluation.
    o A statement that the PLHCP has provided the employee a copy
       of the written recommendations.
   Any employee required for medical reasons to wear a positive
    pressure air purifying respirator will be provided with a powered
    air purifying respirator.
   After an employee has received clearance and begun to wear his or
    her respirator, additional medical evaluations will be provided
    under the following circumstances:
   Employee reports signs and/or symptoms related to their ability to
    use a respirator, such as shortness of breath, dizziness, chest pains,
    or wheezing.
   The (Clinic name) clinic physician or supervisor informs the
    Program Administrator that the employee needs to be reevaluated;
   Information from this program, including observations made
    during fit testing and program evaluation, indicates a need for
   A change occurs in workplace conditions that may result in an
    increased physiological burden on the employee.
   All examinations and questionnaires are to remain confidential
    between the employee and the physician.

Fit Testing
Employees who are required to wear a positive or negative tight fitting
respirators must be fit tested with the same make, model, style, and size
of respirator that will be used.
Employees are required to be fit tested:
    Prior to being allowed to wear any respirator with a tight fitting
    Annually.
    When there are changes in the employee's physical condition that
      could affect respiratory fit (e.g., obvious change in body weight,
      facial scarring, dental changes etc.).
      Employees must pass an appropriate qualitative or quantitative fit
      test as stated in 29 CFR 1910.134(f).

Fit tests will be qualitative fit test (QLFT) or quantitative fit test (QNFT)
and will be administered according to Appendix A of 29 CFR 1910.134.

The type of fit test administered will be determined by the type of
respirator worn and the fit factor that is required to be achieved.

                                                    QLFT QNFT
           Filtering facepiece                       Yes  No
           Half-Face, Negative Pressure, APR (<100   Yes  Yes
           fit factor)
           Full-Face, Negative Pressure, APR (<100   Yes  Yes
           fit factor) used in atmospheres up to 10
           times the PEL
           Full-Face, Negative Pressure, APR (>100   No   Yes
           fit factor)
           PAPR                                      Yes  Yes
           Supplied-Air Respirators (SAR), or        No   Yes
           SCBA used in Negative Pressure
           (Demand Mode) (>100 fit factor)
           Supplied-Air Respirators (SAR), or        Yes  Yes
           SCBA used in Positive Pressure (Pressure
           Demand Mode)
           SCBA - Structural Fire Fighting, Positive        Yes          Yes
           SCBA/SAR - IDLH, Positive Pressure               Yes        Yes
           Mouthbit Respirators                             Fit-testing Not
           Loose-fitting Respirators (e.g., hoods,             Required

The Program Administrator will provide an employee with an
opportunity to select a different respirator and to be retested if the
employee determines the fit of the respirator is unacceptable.

Respirator Use
Respiratory protection is required for the following:
   Employees are not permitted to wear tight-fitting respirators if they
     have any condition, such as facial scars, facial hair, or missing
     dentures, that prevents them from achieving good seal. Employees
     are not permitted to wear headphones, jewelry, or other articles
     that may interfere with the facepiece-to-face seal. If an employee
     wears corrective glasses or goggles it must not interfere with the
     facepiece to face seal.
   All employees shall conduct user seal checks each time that they
     wear their respirator. Employees must use a positive and negative
     pressure check specified in Appendix B-1 of the Respiratory
     Protection Standard or respirator manufactures recommended user
     seal check method.
   The effectiveness of respirators will be reevaluated whenever there
     is a change in work area conditions or degree of employee

All employees must leave the work area for the following reasons:
   To wash their face and respirator to prevent eye or skin irritation
   If they detect vapor or gas breakthrough, changed in breathing
     resistance, or leakage of the facepiece.
   To replace the respirator or the filter cartridge or canister.
  NOTE: The respirator must be replace if the employee detects vapor
  or gas breakthrough, changes in breathing resistance or leakage of the

All employees shall be permitted to leave the work area to go to the
locker room to maintain their respirator for the following reasons: to
clean their respirator if the respirator is impeding their ability to work,
change filters or cartridges, replace parts, or to inspect respirator if it
stops functioning as intended. Employees should notify their supervisor
before leaving the area.
Employees will use their respirators under conditions specified by this
program, and in accordance with the training they receive on the use of
each particular model. In addition, the respirator shall not be used in a
manner for which it is not certified by NIOSH or by its manufacturer.

Procedures for Immediately Dangerous to Life and Health (IDLH)
These areas are identified as potential IDLH atmospheres if an employee
has to enter and IDLH atmosphere then the following procedures must
be followed:

One employee or, when needed more than one employee need to be
located outside the IDLH atmosphere.

Maintain constant visual, voice or signal line communication between
employee in the IDLH atmosphere and employee outside the IDLH
atmosphere (standby person).

The standby person will be trained and equipped to provide effective
emergency rescue.

Standby person must notify employer before entering IDLH atmosphere
to provide emergency rescue.

Standby person will be equipped with the following:
   Pressure demand or other positive pressure SCBAs, or a pressure
    demand or other positive pressure supplied-air respirator with
    auxiliary SCBA; and either
   Appropriate retrieval equipment for removing the employee(s)
    who enter(s) these hazardous atmospheres where retrieval
    equipment would contribute to the rescue of the employee(s) and
    would not increase the overall risk resulting from entry; or
   Equivalent means for rescue where retrieval equipment is not
    required because of increase of overall risk resulting from entry
    into or rescue from the IDLH environment.

Procedures for Interior Structural Fire Fighting (fires beyond
incipient stage)
Employees must use the following:

   All procedures for IDLH atmosphere.
   At least two employees enter the IDLH atmosphere and remain in
    visual or voice contact with one another at all times;
   At least two employees are located outside the IDLH atmosphere;
   All employees engaged in interior structural firefighting use

Cleaning & Disinfecting
(Company Name) will provide a clean sanitary respirator in good
working order for employee use.
Respirators are to be regularly cleaned and disinfected using procedures
in Appendix B2 of 29 CRF 1910.134 or respirator manufacturer’s
procedure if at least as effective as Appendix B2.
The following respirator cleaning and disinfecting schedule will be
    As often as necessary to be maintained in a sanitary condition
    Before being worn by different individuals
    After emergency use,, fit testing, and training

Respirators will be stored as follows:
   In (location) to protect them from damage, contamination, dust,
    sunlight, extreme temperatures, excessive moisture, and damaging
    chemicals, and they shall be packed or stored to prevent
    deformation of the facepiece and exhalation valve.

   In addition to above emergency respirators will be accessible to
    work area, clearly marked as containing emergency respirator, and
    stored in accordance with any applicable manufacture instructions.

When To Inspect
All respirators used in routine situations before each use and during

Emergency respirators will be inspected as least monthly and in
accordance with the manufacturer's recommendations, and shall be
checked for proper function before and after each use.

Emergency escape-only respirators shall be inspected before being
carried into the workplace for use.

Self contained breathing apparatus (SCBA) will be inspected monthly.

What To Inspect
Tightness of connections

Condition of the various parts including but not limited to:

   Facepiece:
    o cracks, tears, or holes facemask distortion cracked or loose
   Headstraps:
    o breaks or tears broken buckles
   Valves:
    o residue or dirt cracks or tears in valve material
   Connecting Tube
    o Kinks, tears, holes, brittle
   Cartridges/canisters:
    o approval designation gaskets cracks or dents in housing proper
       cartridge for hazard
   Elastic parts
    o Pliability, signs of deterioration

Air and oxygen cylinders will be maintained in a fully charged state and
recharged when pressure falls to 90% of manufactures recommended
pressure level. Check proper function of regulator and warning device.

Employees are permitted to leave their work area to perform limited
maintenance on their respirator in a designated area that is free of
respiratory hazards. Situations when this is permitted include to wash
their face and respirator facepiece to prevent any eye or skin irritation, to
replace the filter, cartridge or canister, and if they detect vapor or gas
breakthrough or leakage in the facepiece or if they detect any other
damage to the respirator or its components.

Emergency Respirators
Emergency respirators will be certified by documenting:

     Date of inspection
     Name or signature of inspector
     Findings
     Corrective action
     Means of identification such as a serial number

Defective Respirators
Defective respirators will be removed from service and will be discarded
or repaired according to the following procedure:

   Appropriate training personnel will repair or adjust respirator using
    only approved NIOSH approved parts designed for that respirator.

   According to manufactures recommendations and specifications
    for type and extent of repairs to be performed
   Reducing and admission valves, regulators, and alarms will be
    adjusted or repaired only by the manufacturer or a technician
    trained by the manufacturer.

Breathing Air Quality and Use
Employees using atmosphere supplying respirators (supplied air and
SCBA) will be provided with high purity breathing gases

   Compressed breathing air will meet at least the required of Grade
    D air to include:
   Oxygen content (v/v) of 19.5-23.5%
   Hydrocarbon (condensed) content of 5 milligrams per cubic meter
    of air or less;
   Carbon monoxide (CO) content of 10 ppm or less
   Carbon dioxide content of 1,000 ppm or less
   Lack of noticeable odor
    Cylinders used to supply breathing air to respirators will meet the
   Cylinders must be constructed, tested and maintained in
    accordance with the shipping container specification regulations of
    the Department of Transportation (DOT) 49 CRF Parts 173 and
   Cylinder must have a certification of analysis from the supplied for
    Grade D breathing air.

Compressors used to supply breathing will be constructed and situated
so at to:
    Prevent contaminants from entering supplied air system
    Have in-line air purifying sorbent beds and filters which will be
       maintained, replaced, or refurbished following the manufactures
    A tag containing the most recent change date and signature of
       person authorized to perform the change will be maintained at the
Non-oil lubricated compressors will not exceed 10 ppm carbon
monoxide in the breathing air.

Oil-lubricated compressors, will use a high-temperature or carbon
monoxide alarm, or both, to monitor carbon monoxide levels. If only
high-temperature alarms are used, the air supply shall be monitored at
intervals sufficient to prevent carbon monoxide in the breathing air from
exceeding 10 ppm.

Breathing air couplings will be incompatible with outlets for non-
reparable worksite air or other gas system.

Breathing gas containers will be marked in accordance with the NIOSH
respirator certification standard 42 CFR Part 84

Training and Information
Comprehensive and understandable training will be provided to
employees prior to respirator use and of least annually as follows:

   Basic information in Appendix D of 29 CFR 1910.134 for
    voluntary respirator use in written or oral format.
   Why the respirator is necessary and how improper fit, usage, or
    maintenance can compromise the protective effect of the respirator
   What the limitations and capabilities of the respirator are
   How to use the respirator effectively in emergency situations,
    including situations in which the respirator malfunctions
   How to inspect, put on and remove, use, and check the seals of the

   What the procedures are for maintenance and storage of the
   How to recognize medical signs and symptoms that may limit or
    prevent the effective use of respirators
   The general requirements of this section
   The existence, location, and availability of any records covered by
    this section
   The person responsible for maintaining and providing access to
   Each employee's rights of access to these records

Retraining will be administered when there are changes in the
workplace, inadequacies in the employee’s knowledge, and any other
situation to ensure safe respirator use.

5.0 Program Evaluation
The Program Administrator will conduct periodic evaluations of the
workplace to ensure that the provisions of this program are being
implemented. The evaluations will include regular consultations with
employees who use respirators and their supervisors, site inspections, air
monitoring and a review of records.

Factors to be assessed include but not limited to:
   Respirator fit (including the ability to use the respirator without
     interfering with effective workplace performance
   Appropriate respirator selection for the hazards to which the
     employee is exposed
   Proper respirator use under the workplace conditions the employee
   Proper respirator maintenance

Any problems identified during this assessment will be corrected and
noted in an inspection log.

6.0 Recordkeeping
Written information regarding medical evaluations, fit testing, and the
respirator program will be maintained in (location)

Medical evaluation must be retained for at least the duration of
employment plus 30 years.

Qualitative and quantitative fit test records will include the following:
   The name or identification of the employee tested
   Type of fit test performed
 Specific make, model, style, and size of respirator tested
 Date of test
 The pass/fail results for QLFTs or the fit factor and strip chart
  recording or other recording of the test results for QNFTs
 Fit testing records will be retained until the next fit test is

To top